Ethanol As a Household Fuel: Analysis of Impact on Exposure Indoors Air Pollution Health

This study sought to evaluate the effectiveness of three household energy interventions and an awareness-raising campaign in comparison to a control group in one highland location (Ambositra) and one coastal location (Vatomandry).  The primary intervention in both locations was an imported ethanol cook stove, which was found to reduce women exposure to CO significantly by between 75% (highland households) and 54% (costal location) and child exposure by 60% (highland) and a non-significant reduction of 14% in the costal community from the open fire and traditional charcoal stove baselines.  Reductions in kitchen concentrations of CO and PM_2.5 were also significant.  Modelling of impacts on child pneumonia show that widespread adoption of ethanol stoves in Madagascar steadily increasing over a 10-year period at a rate that would see universal access by 2030, would avert around 9,000 deaths from this cause by 2020.  This ‘ideal scenario’, however, assumes full use of ethanol, and given the results found in this study, about one-third of this impact can be expected.  A Malagasy improved wood stove with chimney, also tested in this study, showed some promise in reducing pollution exposures (a significant reduction of exposure to CO in children of 31%), a finding that is relevant to the large numbers of households in rural areas who rely on wood fuel and are likely to continue to do so far into the future.